My name is David Adam and I have
obsessive-compulsive disorder - OCD. I want
to find out more about my condition so
I've come to the University of Cambridge
to find out how some of the top scientists
in the field are studying this disorder.
I've seen how they use animals to
understand whats going on in the brain but
OCD is a human condition so how does
this research relate to the human brain?
I've come today to meet Dr. Annemieke Apergis-Schoute
who uses cognitive tasks very
similar to those we've just seen carried
out on animals but using human
volunteers and today - that's me.
Ultimately of course, scientists need
to compare what they've learned from
animals with what is happening in the
human brain. Cognitive tests can tell us a
great deal about the OCD brain but to
see which areas of my brain and involved
in my OCD Annemieke is going to conduct
a similar case while imaging my brain in
a brain scanner 60,000 times the
strength of the Earth's magnetic field.
So David you're about to go into the
scanner, okay, where you just be laying
down and watching a screen and you'll
see two angry male faces and your job
is to figure out after which face you
might be getting a shock. Okay. At same
time we will be recording your skin
conductance where we can see tiny
changes in your sweat to see when you
might be expecting a shock and you also
have a shock electrode on your other
wrist
through which you'll be getting thosel
little shocks.
Okay so David you were just in the
scanner, what did you notice when about
when you were getting shocks?
So, at the beginning I definitely felt that I was
getting shocks from the green faces and
then I got a bit confused because the
red faces seemed to join in.
Well that's very interesting because that's what we
overall find in OCD patients, that
initially they realize they're getting
shocks to the green face and that the
other one is safe as we see by their
skin conductance responses but in the
middle when unexpectedly now the red
face is giving shocks and now the green
one has become safe there is no
difference between your skin conductance
responses in this part and what we see
from the OCD patients in their brain is
that they have a region here in the
medial front part of the brain that is
hyperactive throughout differentiating
these two faces. So in the
healthy controls we see that this region
actually signals when it stimulates his
face but it doesn't seem to do this for
the OCD patient.
Okay so that's something that you can look at in the
human brain and there are people like me who
are very happy to volunteer for you to
have a look in our brain. So once again
it asks the question - why bring the
animals into it?
So with humans we can
see correlations between brain regions
and what happens when they do a certain
task but we can't see things on the
neuronal level and we also can't
manipulate the brain so we can't stimulate
a certain region or maybe even ablate a
certain region - take it out. We can't put
drugs in to see what happens if the
levels of certain neurotransmitters
change. So in an animal we can model, we
can do a lot more that we're not able to
do in humans on that much more specific level.
So that bit you pointed to - the
bit that you think's implicated
in OCD, it looks quite difficult to get to?
Yes well, it is it's all the way in
the in the middle, on the bottom of your
frontal cortex and actually with deep
brain stimulation they have to go very
deep into the brain to stimulate and
they are able to do that when they go in
from an angle.
Deep brain stimulation, what's that?
Deep brain stimulation is
when you get electrodes placed in regions
of the basal ganglia which are deep into
your brain and you sort of have a
pacemaker for the brain, that's always on
and stimulating at a certain frequency.
So we're actually right now doing the
first deep brain stimulation trial in
collaboration with University College
London where we have the first six
patients signed up and we're really
hopeful that this will be an opportunity
to give them their life back from OCD.
So, I've seen some of the research now at
the University and I came in interested
and a little skeptical about the animal
research but I think what is most
striking for me now are those images of my
own brain and seeing those on the
computer screen it is quite humbling and
it's also quite emotional for me because
of course that that's where it all began.
And I think we like to think of the
brain as being so uniquely human and of
course it is they're also seeing it in
that way cutaway made me realize that
the I'm an animal and and and my brain
is it apart of my my body in the way
that the other organs are and when the
other organs go wrong we try and treat
them and and so it is with the brain but
we're probably not as advanced with some
of those treatments and certainly not
with those OCD. It's worth remembering
that the treatments for OCD are, they're
better than they used to be and they
help people, certainly they certainly
helped me but they don't help everybody
and and they're not particularly good
for some people and so we need to keep
trying to find better treatments and-
I think if I'm honest I think some of
the research that I've seen probably
probably won't lead to any breakthroughs
certainly in in time to help me, but
hopefully in time to help the next
generation. And you know if we want
to try and develop better treatments and
new treatments then I think we do need to
treat the brain like any other part of
the body we do need to experiment with
it and we do need to find out what goes
wrong and I guess we can't do, we can't do
that work with human so so I think we
have to do some of that with animals
just to maybe not to develop new
treatment immediately as some people
might talk about but mainly just to give
us the knowledge to try and improve and
develop new treatments in the future
because I think sadly as far as my
generation goes and me is probably it's
probably too late you know we have to
make do with the rather crude tools and
treatments we have now but but
hopefully, for the next generation
- it's not too late.